My Birth Plan.. To much?

[hawalkden]

HEATHER WALKDEN & JASON HOPSON BIRTH PREFERENCES
Guess Date: 10 December 2011 – Burnley General Hopsital --- Consultant: Dr XX
ABOUT US
• My name is Heather and my Fiancé is Jason.
• This is our first child. I have had few complications within the pregnancy. I have cervisitis twice (25 and 30 weeks). Also suffered with sciatica.
• We haven’t attended any antenatal classes.
• I have Type One Diabetes and I’m on the Insulin Pump.
Environment
• I would like the have low lighting and have the radio on when the room isn’t occupied with medical staff.
• I would like Jason to be with me at all times and whenever an examination is being done.
• I would like a student midwife or doctor to be within the room but please no men to exam me.
• We would like each person attending me to read my birth preferences and introduce themselves.
FRIST STAGE – Thinning & Opening
• I would like Jason to be with me after the first course of induction gel is applied.
• I would like if possible to have my Insulin Pump on me at the first stage point before contractions or water break. That is when I’d like the Insulin Sliding Scale IV Drip is put up.
• I would like to monitor my own blood sugar with my own device when asked off medical staff and I’d like to eat and drink when I want and only if a Doctor requires me not to do it due to an emergency c-section is talked about.


Pain Relief
• Our preference is for an epidural when I feel the discomfort is going to get worse and longer them I thought it’d be.
• I would like to be offered Gas & Air and will use of breathing, massage & relaxation techniques.
Monitoring & Examinations
• I am not bothered about being internally examined. I don’t want to be disturbed if I am asleep, comfortable and access can’t be given.
• Monitoring I am happy with. I would like though if the monitoring of the baby is going okay and no worries are raised. I’d like to have a break to walk around.
Positions for Labour
• If possible to be able to use the bed in different positions.
• Recommendations off medical staff too.
Eating & Drinking
We will take snacks and water for both Jason and I. Please remind me to drink and use the bathroom.
SECOND STAGE – Birthing
• I would like to have guidance if I don’t have an epidural for pushing time.
• I would like to have my own clothes on and if I feel the need to I would like to be naked and bed sheets off me.
• I would like a cold flannel to be used on me and Jason to assist me with that request.
Perineum
• I would like to have a episiotomy if needed.
• I would prefer any tear to be sutured by my female midwife or female doctor and not a student.
Birthing Baby
• We would like Jason or I to pick up our baby immediately and determine the sex ourselves.
• We would like skin to skin contact and time to bond with the baby.
• If I require an assisted delivery, please use a ventouse in favour of forceps. This assisted delivery to be used as a last resort.
• In case of emergency / assisted breathing please bring the trolley to the baby and leave cord on.
• Jason will stay with our baby if there is any emergency.
THIRD STAGE - Placenta Delivery
• I want a physiological third stage and would like to try breast feeding to assist natural delivery.
• We would rather the mid-wife clamp / cut the cord when pulsation has stopped.
• Please no cord traction, syntocinon or manual removal unless there is an emergency.
CARE OF OUR BABY
• I am going to breastfeed my baby so need undisturbed skin to skin contact after the birth.
• I would like the Vitamin K to be given.
IN THE EVENT OF A CAESAREAN
• I am keen to avoid a caesarean & will only agree to one for a genuine medical emergency.
• Please do not perform a hysterectomy unless it is the only option available to save my life.
• If emergency caesarean required I would like to remain awake & request an epidural or spinal block.
• I would like to breastfeed the baby as soon after birth as possible.
• I would like to hold my baby straight away.
• I do not want baby taken out of theatre unless it is an emergency.
• I would like support with breastfeeding as I will find it difficult to move after the operation.
• If my baby needs to go to special care then Jason, will go with him/her.
• I wish to be kept informed of baby’s well being and start expressing if baby goes into special care.
OUR CONSIDERATIONS
• We appreciate that we must be flexible in our choices if things do not evolve in the way we wish.
• We request that all options are examined and that we are given accurate information.
• We gratefully respect that we are given sufficient time to discuss the proposed course of action.
• In the event of any emergency situation, then you will have our full co-operation.
• The safety of our baby and mum is paramount and we do not wish to put either in any danger.
• We would like only Jason, myself and medical staff within the room at all times and no visitors to be invited in.

 

[Lisa83]

I know all hospitals are different however my hospital (northern Ireland) would not even read through this, so check it with MW or doc before labour .. Guidelines at my hospital are to keep your birth plan short & simple, and only include any details of anything you 100% defo do or don't want .. As long as your birth partner knows your preferences during labour, and ur plan is short & simple you will be fine & get the things you want .. I mean if an emergency came up do you think they will read through this to find the part about your preferences on emergencys?

I understand that a birth plan is what you would like in labour, but my advice would be to let your MW who will be present at birth see your plan as soon as possible and ask her opinion as in my opinion it's way to long, and you wouldn't want to miss out on your definate preferences coz of a long long birthplan they prob won't have time or be bothered to read xx

 

[amerikiwi]

I think it's fantastic that you have put so much thought into it. Make sure your DH knows everything that is in and is willing to stand up for you.

As for the official birth plan goes, I'd simplify it. As said above, choose the most import things that you feel 100% on and will not budge on and leave the rest to your DH to advocate on your behalf.

Personally things i'd keep in are insulin pump, no male to examine, student OK, staff to introduce selves, vontous over forcep, cord preferences, skin to skin, vit K, you and DH to determine gender, DH to accompany baby if baby is out of room, and no visitors.

 

[Leopard]

Looks bloody good to me

 

[AimeeM]

That is a great birth plan. They do read them at my hospital as she came and asked me if I would change my mind about not wanting a student to help with the delivery. This wasn't spoke about but was on my birth plan.

Do remember though that in an emergency some things wont be possible, such as bringing the table over to the baby in an emergency to resuscitate. I am not sure they would do this? Do they resus with the cord still attached? I may be thick but I thought the baby doesn't take a proper breath until the cord is cut. I don't know if this is possible as the cord probably wont be too long and mine was on the table way before the placenta was delivered.

I wanted to leave the cord to stop pulsating and have him straight on me but he needed help with breathing and oxygen on the table and they had to cut the cord which at the time I couldn't care less about as long as he was ok.

 

[mummymarsh]

i think thats quite a lot to read... and lots of it isnt necessary unless in emergency and anyway they check with you then.. they dont do anything without yours or next of kins consent....

if you look on the NHS choices website you can do an electronic one and that gives you main points and ideas...

i think what you have got in there is good it can just be shortened and simplified....

when i was transfered to hospital with my 1st (i orginially chose midwife led unit) they didnt even read my birht plan and gave me placenta delivering injection which i had written in my notes i wanted to avoid....

that was annoying so be clear at time what you want and dont want, dont rely on what you have written...

 

[myasmumma]

i personally dont think that the bits about your pregnancy is needed as they will know this by looking at your pregnancy notes everything else looks good though short and to the point

 

[Caroline:-)]

I didn't write a birth plan, and at no point did anyone ever ask me whether I had one... IMO, the important thing i to make sure your birth partner knows your wishes so if you are unable to voice the opinions youself he can do so... TBH, there is no way of knowing how the birth will go or how you will cope with it, so I just decided to go with the flow. Also, you may change your mind about what you want when you are actually there - it's never going to be anything like you imagine!!!! In my experience the midwives, etc will ask you what you want or just do what they have to do! Nothing about my labour/birth was what I would have planned, so I'm glad I didn't bother writing one!!! As mummymarsh said, they may not even read it so I'd say it's more important for you and/or your partner to make sure you verbally tell them what you want...And as AimeeM said, in an emergency situation they're unlikely to really worry about your request to bring the trolley to the baby, etc - they will just do what they need to do and what they've been trained to do in thast situation... I'm not saying don't have a birth plan (although I would simplify it a bit... I agree with Lisa83, it's way too long and convoluted for them to even want to read! Especially in an emergency situation!) just don't rely on it and make sure you are clear about your wishes at the time. GL x

 

[miss_if_only]

A lot of the time your partner will need to be your go between to convey your wishes and ensure things are going the way you and he wants.

With this in mind, and the fact men are not good at remembering things during stressful moments, try to keep it as simple as possible for him, and give him his best chance to shine...

 

[LouLou78]

Hi there, I do think this could be shortened a bit. Unfortunately the midwife will already have alot of paperwork to complete and medical notes to read as well as providing care. She may not be able to have time to read all of it and take in every point.

I do think keep the personal bits, like the fact that you would like low lighting and music as this is personal to you. Whether you would like a student present is another good point. However, there are things which go without saying really.

For example, I don't think your partner Jason would be asked to leave during vaginal examinations. Correct me if I am wrong I am unaware of places kicking partners out during procedures and would always include the partner at all times. Just like some people can say that they would rather partner not be present for certain things if you wish at the time.

'We would like each person attending me to read my birth preferences and introduce themselves'

The comment above I think definately goes without saying and could come across as patronising really. Including when your IV insulin is put up. This would be down to circumstances in your care and drug guidelines not personal preference. Not something you can dictate really. Also, you don't really need to say that you need guidance for pushing with an epidural. It is automatic that a health profession would recognise this need.

Also, if you did require an instrumental delivery, all doctors prefer to use a ventouse anyway but unfortunately this is a clinical decision and there are certain positions that can only be delivered with forceps. Forceps unfortunately have their place. Certainly it is not used as a first resort. Drs would rather you deliver by yourself without needing anything at all. This goes without saying really.

Also in cases of neonatal emergency. The baby would have to go onto the resuscitaire. Resuscitating a baby on the bed still connected to the umbilical cord won't allow adequate resuscitation if required. For a start, chest compressions have to take place on a hard surface. Adequate oxygen via the resuscitare is just at the right flow and volume for the baby and the tubing cannot extend far enough.

Also a hysterectomy is only a life saving procedure and even when this is required your family would be consulted and requested permission if they have been called in. This isn't taken lightly.

I do hope this helps.

 

[amjon]

That is a great birth plan. They do read them at my hospital as she came and asked me if I would change my mind about not wanting a student to help with the delivery. This wasn't spoke about but was on my birth plan.

Do remember though that in an emergency some things wont be possible, such as bringing the table over to the baby in an emergency to resuscitate. I am not sure they would do this? Do they resus with the cord still attached? I may be thick but I thought the baby doesn't take a proper breath until the cord is cut. I don't know if this is possible as the cord probably wont be too long and mine was on the table way before the placenta was delivered.

I wanted to leave the cord to stop pulsating and have him straight on me but he needed help with breathing and oxygen on the table and they had to cut the cord which at the time I couldn't care less about as long as he was ok.

If the baby is having trouble breathing the cord should NOT be cut as it still provides oxygen through the blood (as long as the placenta has not separated yet). I would not want the cord cut if the baby was having trouble breathing. That may be the only thing that keeps them alive long enough to start breathing.

 

[LouLou78]

If all baby needed is stimulation then yeah keep connected to the cord but if the baby comes out in poor condition, not breathing or gasping, blue, requiring breaths and appears in this condition despite being attached to the cord then that baby needs to be taken straight to the resuscitaire to commence inflations breaths, unfortunately resuscitaires are not able to be brought close enough to the woman so the cord would need to be cut. I do think that hospitals need to bring in the benefits of delayed cord clamping and resuscitation. But also understand that the ergonomics in a labour room simply wouldn't support this. At a home delivery resuscitation can take place close to mum on the floor with cord attached and equipment needed brought to mum.